Active NPI
Dominic Fetterly, DC
- Chiropractor
- Battle Creek, MI
National Provider Identifier
1861972309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2301010700
- Practice address
- 601 S Shore Dr Unit 121
Battle Creek, MI 49014-5440 - Phone
- (269) 963-3072
- NPI assigned
- Aug 15, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Chiropractor | 111NN0400X | 2301010700 | MI | |
| Chiropractor | 111N00000X | 2301010700 | MI | Primary |
Addresses
Primary practice location
601 S Shore Dr Unit 121
Battle Creek, MI 49014-5440
Mailing address
601 S Shore Dr Unit 121
Battle Creek, MI 49014-5440
Phone (269) 963-3072
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2301010700 | MI | MD | Neurology Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544486400000",
"number": "1861972309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 S SHORE DR UNIT 121",
"city": "BATTLE CREEK",
"state": "MI",
"postal_code": "490145440",
"telephone_number": "269-963-3072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 S SHORE DR UNIT 121",
"city": "BATTLE CREEK",
"state": "MI",
"postal_code": "490145440",
"telephone_number": "269-963-3072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FETTERLY",
"first_name": "DOMINIC",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-15",
"last_updated": "2018-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "111NN0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Neurology",
"state": "MI",
"license": "2301010700",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "2301010700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Battle Creek, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.